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[6] Concomitant use with oral anticoagulants such as warfarin may enhance anticoagulation and alter international normalised ratio values, so prothrombin time should be reviewed more frequently following dose changes of either drug

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If patients are to start NASCOBAL before having tolerated cyanocobalamin parenterally, consider administering an intradermal test dose of parenteral vitamin B12 to patients suspected of cyanocobalamin hypersensitivity